What's the Prognosis When Asymptomatic Carotid Stenosis Progresses to Occlusion?

Allan S. Brett, MD reviewing Yang C et al. JAMA Neurol 2015 Sep 21.

In one retrospective study, the stroke rate was remarkably low.

We tend to assume that patients with asymptomatic carotid stenosis are at high risk for stroke if stenosis progresses to total occlusion. To explore this assumption, Canadian researchers analyzed data, collected from stroke prevention clinics between 1990 and 2014, on 3681 patients with asymptomatic carotid disease who underwent annual carotid ultrasonography.

A total of 316 patients (9%) developed carotid occlusion; of these, only 1 patient had an ipsilateral stroke at the time of the occlusion, and only 3 patients suffered strokes during average follow-up of 3 years (maximum follow-up, 20 years) after occlusion was documented. Most occlusions developed before 2002, the year when more-intensive medical therapy began to be implemented in this cohort.

Citation(s):

Yang C et al. Risk of stroke at the time of carotid occlusion. JAMA Neurol 2015 Sep 21; [e-pub].